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With 120 HIV infected inmates, Yerawada tops prisons in state

PUNE: In the cramped, often unhygienic conditions of the 29 central and district jails in the state where medical care is down to the basics, 467 inmates have tested positive for HIV infection in the last two years. Yerawada Central Jail in Pune has 120 HIV infected inmates, the highest in the state.

PUNE: In the cramped, often unhygienic conditions of the 29 central and district jails in the state where medical care is down to the basics, 467 inmates have tested positive for HIV infection in the last two years. Yerawada Central Jail in Pune has 120 HIV infected inmates, the highest in the state.

“A total 21,404 prisoners in Maharashtra’s prisons were screened in the last two years. Of them, 4,472 inmates were from Yerawada Central Jail. Among them, 120 were detected with HIV infection which is the highest in the state,” said Dilip Deshmukh, additional project director of the Maharashtra State AIDS Control Society (MSACS) told TOI on Monday

Of the 467 HIV infected prisoners, 87 have been put on antiretroviral treatment as their CD4 count is less than 250, said Deshmukh.

CD4 cells are specialised cells that protect the body. HIV attacks these cells and uses them to spread the virus which weakens the immune system.

People without HIV infection have about 700 to 1000 CD4 cells in a drop of blood. HIV infected people are considered to have normal CD4 counts if the number is above 500 CD4 cells in on blood drop.

Health experts say that prisoners can be HIV infected if they participate in unprotected sex or share infected needles while using illicit drugs.

They also maintained that the HIV infection rate among prisoners was lower than the general populace that came for testing to integrated counselling and treatment centres at hospitals.

“The prevalence rate comes to 2.18 per cent of the total number of prisoners which is below the 4.7 per cent incidence rate in the general population coming to ICTCs for testing,” said Deshmukh.

“The presence of HIV infected persons and those at high risk in prisons is a critical challenge. Unlike the general population, many prisoners may not be aware if they are infected with HIV. Often, vastly crowded living conditions lead to such behaviour among prisoners,” said A L Kakrani, professor and head department of medicine D Y Patil Medical College. He is also an ex-member of the technical resource group of the Government of India on ART.

“The tedious prison environment, lack of occupation of mind and body and plain boredom lead to accumulated frustration and tension. This environment leads to the high-risk activities such as use of drugs and unprotected sex between men,” Kakrani said.

The history of five HIV infected inmates at Yerawada jail has revealed that they were MSM (men having sex with men), said Sudhakar Ingale, counsellor of the ICTC centre at the jail. “We are spreading awareness about the risks associated with MSM among the prisoners,” he said.

A recent UNAIDS report says that the HIV epidemic in Asia was concentrated largely among people who inject drugs, sex workers (FSW) and their clients, and MSMs. About 90 per cent of those newly infected with HIV in India were believed to have acquired it during unprotected sex.

The ICTC facilities

The Integrated Counselling and Testing Centre (ICTC) facilities were started at Yerawada and Amravati jails by the MSACS as a pilot project on October 2, 2008 . The move came following a directive by the Bombay High Court.

The ICTC facilities with full-time counsellors and technicians have been started at five more jails including Nashik, Taloja, Kolhapur, Aurangabad and Nagpur. The other jails in the state send the inmates for testing and counselling to government hospitals that have ICTC facilities.

“There are no plans to set up full-fledged ICTCs in all the prisons in the state. Earlier, a proposal was sent to the National AIDS Control Society of India (NACO), but they are ready to extend only training if the state government recruits workforce,” said Deshmukh.

An integrated counselling and testing centre is a place where a person is counselled and tested for HIV, on his own free will or as advised by a medical practitioner. The main functions of an ICTC include counselling and testing for HIV, creating awareness on modes of transmission, prevention of HIV/AIDS for promoting behavioural change and reducing vulnerability.